Effects of peroperative intravenous paracetamol and lornoxicam for lumbar disc surgery on postoperative pain and opioid consumption: A randomized, prospective, placebo-controlled study

Abstract

Effects of peroperative intravenous paracetamol and lornoxicam for lumbar disc surgery on postoperative pain and opioid consumption: A randomized, prospective, placebo-controlled study Lomber O R I G I N A L A R T I C L E PAIN A RI SummaryObjectives: The aim of the present randomized, placebo-controlled study was to compare postoperative analgesic effects of peroperative paracetamol and lornoxicam administration. Methods: Sixty adult patients with American Society of Anesthesiologists (ASA) risk classification I-II, who would undergo single-level lumbar discectomy under general anesthesia, were enrolled. Patients were administered either 1000 mg paracetamol (Group P), 8 mg lornoxicam (Group L), or saline (Group C) prior to induction of anesthesia (n=20 for all groups). All patients were administered the same anesthesia induction and maintainance. Postoperative analgesia was maintained with the same analgesic drug in each group. Rescue analgesia was supplied with intravenous meperidine delivered by a patient-controlled analgesia device. Numeric rating score (NRS) results, first analgesic demand time, and cumulative meperidine consumption were recorded postoperatively. Primary outcome was NRS at first postoperative hour. Secondary outcome was measure of opioid consumption during first 24 postoperative hours. Results: At first postoperative hour, NRS of Group L [4 (0-8)] was lower than NRSs of Groups P and C [6(0-7); 6(0-9), respectively; p<0.016]. Time to first analgesic demand of Group L was longer, compared with those of the other groups (p<0.016). Cumulative postoperative meperidine consumption in Group L was less than those of Groups P and C at 2-, 12-, and 24-hour time intervals (p<0.016), while Groups P and C had similar findings for the same time intervals. Conclusion: Preoperative lornoxicam administration decreased early postoperative pain scores more effectively than paracetamol.Keywords: Lumbar disc surgery; paracetamol; lornoxicam; postoperative pain; patient-controlled analgesia. ÖzetAmaç: Bu randomize plasebo kontrollü araştırmanın amacı peroperatif lornoksikam ve parasetamol kullanımının postoperatif analjezik etkilerini karşılaştırmaktır. Gereç ve Yöntem: ASA I-II risk grubunda tek seviye lomber diskektomi yapılması planlanan 60 hasta çalışmaya alındı. Hastalara 1000 mg parasetamol (Group P Kümülatif meperidin kullanımı postoperatif 2-12 ve 24. saatlerde Grup L'de diğer iki gruba göre daha azdı (p<0.016). Aynı zaman dilimlerinde Grup P ve S benzer bulgulara sahipti. Sonuç: Preoperatif lornoksikam uygulaması erken postoperatif ağrı skorlarını parasetamole göre daha iyi düşürür.)Anahtar sözcükler: Lomber disk cerrahisi; parasetamol; lornoksikam; postoperatif ağrı; hasta kontrollü analjezi.

Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis

“…It is important to note that the heterogeneity of this meta-analysis was high, and to be conservative in our statistical analysis, the random effects model was used. The decreased consumption of rescue analgesics in the postoperative period is an important finding that has been observed in many surgical areas [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”